Hey ya'll! It has been a while, but I've been inspired to write out some posts again because A. I am back on rotation after a very long 3 months off and B. have had many P3 students reach out to me looking for advice in regards to picking APPEs. Picking your APPEs can be a really overwhelming process, from ranking the sites, to thinking about transportation and also just the general ambiguity about where you'll be next year that hangs overhead. I'm here to tell you: don't fret, it'll all work out. Seriously. The P4 students when I was a P3 picking APPEs told me exactly the same thing and I still worried, but reflecting back now I can see that everything worked out exactly as it should.

1. Think a lot about what you are interested in, what settings you are most excited about, and what you would love to learn more about!

APPEs are your time to explore, so don't choose rotations because you think they'll be "easy". I can't tell you how many times I've heard people say that they were totally committed to doing community pharmacy as a career, went on APPE rotations and ended up applying for residency, or vice-versa. While I definitely recommend choosing a rotation in a career field you think you have an interest in, it is also a great idea to challenge yourself with rotations you know nothing about. You never know how choosing outside your comfort zone will impact your interests and goals! I chose a variety of rotations that I knew I may never get the chance to take elsewhere, like a gastroenterology ambulatory care rotation. I already knew I loved ambulatory care, and chose it as an elective because having it be GI-based was too unique to pass up on!

2. Know that you may not get your first choice in everything

AND THATS OKAY! Story time: I did not rank transplant for my inpatient APPE, at all. So when our APPE algorithm presented me with my first APPE rotation, inpatient transplant at a local hospital, I was surprised but took it in stride knowing that I'd still learn a lot even if I didn't rank the subject. It turned out to be one of the best rotations I had during the whole year, and transplant became my primary interest (and will possibly be the speciality I pursue in a PGY2 residency, granted PGY1 goes okay haha!). So my point is: embrace the rotations that may have not been your first choice, because they can have the most serendipitous effect on your life.

3. You cannot cheat the system

There is no magic way to cheat the algorithm and get your first choice in everything, no matter what the conspiracy theorist in your class says.

4. Ask P4s for their advice

Who better to advise you on which rotations are interesting/fun than the people currently in them!? I've had a ton of P3s reach out to me asking about my experiences in my rotations. Your upperclassmen are your best resources, so utilize them. We've been through it and we'll help you through it too. The best part about seeking out help from P4s is that they can also give you the inside scoop about the stuff that isn't listed in your program's APPE manual but matters just as much: is the train ride sketchy? how is the cafeteria? what does my average day look like at this rotation?

5. Consider your plan for next year when ranking

For example, I lived in Philadelphia during my P3 year and knew that my lease would be up in the summer of my P4 year while I was on APPE. Knowing this I scheduled my last two rotations to be back in NJ, where my family lives, so that I could avoid a commute into Philly. APPEs are tiring, and you're usually there all day. Sometimes you might have to pop in to get extra info on a patient, sometimes you have projects to do that require you to come in as well. Therefore it is good to think about things like: where will I be living? will I have access to a car? will I need time off for a family obligation? etc. It is much better to plan ahead when possible then to figure things out while on APPE when you have a lot more work going on.

That is all the advice I have for now. I know my school in particular is wrapping up their ranking time period but hopefully this will serve as a stress relieving post for those who are wondering whether or not they made the best choices possible. If you've already submitted, relax and keep calm till you hear. It'll all work out and soon enough you'll have your list!